Provider Demographics
NPI:1295418416
Name:BRADFORD, HALEIGH (MS, CF SLP)
Entity type:Individual
Prefix:
First Name:HALEIGH
Middle Name:
Last Name:BRADFORD
Suffix:
Gender:F
Credentials:MS, CF SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S DOGWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761-3922
Mailing Address - Country:US
Mailing Address - Phone:479-524-6184
Mailing Address - Fax:
Practice Address - Street 1:600 S DOGWOOD ST
Practice Address - Street 2:
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-3922
Practice Address - Country:US
Practice Address - Phone:479-524-6184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR202257235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist